Antimicrobial sensitivity pattern of urine isolates from asymptomatic bacteriuria during pregnancy

Screening women for asymptomatic bacteriuria [ASB] on the first antenatal visit is a part of standard obstetric care. Treating women with ASB decreases the chances of maternal and f0etal complications. This study was conducted to find out the spectrum of urine pathogens and their drug susceptibility pattern for ASB during pregnancy. The study was conducted in the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, from September 2001 to March 2002. Two hundred and ninety women, apparently normal with confirmed pregnancy, were registered. A voided midstream urine specimen was collected and cultured. A significant growth i.e. >/= 105 organisms/ml was identified with Analytical Profile Index 20 tests for identification of Enterobacteraceae [API-2o-E] and for Gram positive cocci by other standard methods. The prevalence of ASB was found 6.2%. Antimicrobial sensitivity was determined by disc diffusion Kirby Bauyer method after matching the turbidity with 0.5 McFarland's standard. Most of the recommended drugs were found to have encouraging results, however, Escherichia coli showed 66.67% resistance to ampicillins and sulphonamides. Enterobacters showed 100% resistance to ampicillins, cephalosporins and nitrofurantoin. Staphylococcus saprophyticus showed 66.67% resistance to ampicillins and sulphonamides. It was concluded that detection of ASB during pregnancy and appropriate use of antimicrobials is only possible after culture of urine. Empirical anti-microbial therapy cannot be relied upon because of possible risk of resistance

study of prevalence of malaria in adult population of D.I.Khan, Pakistan

Malaria is a serious global health challenge. It continues to be a threat to the developing countries. Epidemiological data from different regions of Pakistan is insufficient to exactly evaluate the incidence of various types of malaria. D. I. Khan is a hot area on the right bank of the river Indus, providing favourable circumstances for mosquito breeding. We conducted this study to see the prevalence and presentation of various types of malaria in adult patients presenting with fever, and its response to anti-malarial agents in this region. This cross-sectional study was conducted in the department of Medicine, Gomal Medical college, D. I. Khan, from 28[th] August 2005 to 27[th] February 2006. All adult patients presenting to the outpatient clinic with fever were included in the study. A total of 490 patients presented with fever as a chief complaint. After detailed history and thorough clinical examination, Giemsa stained thick and thin blood films were examined. Species determination and parasite count were performed. Patients were grouped into two; Group A having Falciparum malaria and Group B any other type. Group A patients were randomly given either Quinine or Artemnether. Group B patients were given Chloroquine, Quinine or Artemether in standard doses. MP and parasite count were repeated on day 7 and 14 and the presence of more than 25% parasitaemia as compared to pretreatment was taken as treatment failure. Out of 490 patients, ninety-eight [20%] were found positive for malaria, seventy-five males and 23 females. Comparing the symptoms in falciparum and vivax malaria, it was found that nausea/vomiting was twice as common in falciparum malaria. Comparing the anti-malarial drugs, Chloroquine and Quinine were found to be effective in all patients. On the other hand Artemether was found to be 100% effective in vivax malaria and poor response to therapy was observed in two [4%] patients with falciparum malaria. As a conclusion malaria is responsible for fever in every fifth adult patient in our setup. Males are three times more commonly affected than females. Plasmodium falciparumn is 1.5 times more common than vivax. Nausea/vomiting and pallor are more common in falciparum, while splenomegaly is seen in vivax malaria. Commonly used anti-malarial drugs are effective in most of the cases

Study of patients presenting with acute flacid paralysis in Dera Ismail Khan, NWFP - Pakistan

A descriptive study was designed to analyse patients of acute flacid paralysis [AFP] in paediatric deptt of DHQ teaching hospital D. I. Khan during 2002. A total of 36 cases of AFP were reported during this period. They were clinically examined. History was taken with special reference to IM injection and OP vaccination. Stool samples were sent to NIH Islamabad for viral detection. Out of total of 36 patients, 15 were confirmed as polio, 5 were labelled as compatible with polio and 16 were non-polio cases. Out of 15 confirmed cases of polio, 12 [80%] had received IM injections and all had some residual paralysis / weekness after two months follow-up, while 3 of the non polio cases had received I.M. injections and non had residual paralysis / weekness on follow-up. Main cause of high polio prevalence seems to be due to low vaccination rate, particularly routine as compared to supplemental vaccination. It was concluded that supplemental polio vaccination should be continued in an improved and strengthened fession through NIDs and EPI

Mortality rate in adult tetanus patients in district D. I. Khan, NWFP - Pakistan

This study was conduct to know about the real and present situation in our set up where tetanus still remains an important cause of morbidity and mortality despite free availability of a safe and effective vaccine. The study was conducted in medical unit of DHQ teaching hospital D. I. Khan over a period of four years. A total of 150 cases of tetanus were studied with 120 patients being males and 30 females. Diagnosis of tetanus was based on clinical examination. The patients were given conventional therapy for tetanus and comparison was made with other studies. Among these 150 patients of tetanus, 29 [19.3%] patient died, 22 being males and 7 females. Mortality rate in adult patients with tetanus is lower than reported in most other studies

Still birth rate in district head quarter hospital Abbottabad

This retrospective study was done at District Headquarter Hospital, Abbottabad. The prevalence of still birth was studied among 853 infants born in maternity ward of DHQ Hospital, Abbottabad during two and a half years. The still birth rate observed was 112.5/1000. The rate was higher among multigravida and in females of more than 35 years age. The prominent aetiological factors were multiparity prolonged and obstructed labour and antepartum haemorrhage